How can I get malaria pills?

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QUESTION

I do have symptoms of severe malaria. How can I get malarial pills in Holland? I went to the hospital the doctors said nothing is wrong with me which is not true.

ANSWER

If you have the symptoms of severe malaria (high fever, chills, nausea, body aches) then you should go to an emergency room at a hospital immediately.

Malaria infection can be very serious if not treated promptly and with appropriate medicine. You must inform the doctors of your travel and medical history. Malaria is not transmitted in Holland so you must have been infected elsewhere.

Tell the doctors in particular if you have recently (in the past month) travelled to an area where malaria is transmitted (sub-Saharan Africa, South America, some parts of Central America, Haiti, Central Asia, South-East Asia, many of the Pacific Islands). I am certain that if you truly have the symptoms of severe malaria they will not turn you away from the hospital, and especially not if you make it clear that you may have been at risk for malaria.

However, if you have not travelled to malarial areas recently, then it is much less likely you have malaria. However, some forms of malaria can “relapse” after a long dormant period. If you have had malaria previously, and have suffered these relapses, then this is also very important information to tell your doctors.

It is important to take anti-malarial medication only if you have had a blood test to confirm that you have malaria. The symptoms are general enough that they are often mistaken for malaria when they are in fact caused by another disease. Moreover, in most parts of Europe, it is difficult to get malaria medication without a prescription.

It is very important that you visit an emergency room, hospital or your doctor as soon as possible to get tested for malaria and given the appropriate treatment if indeed you test positive for malaria.

Post-infection Malaria Medication

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QUESTION

My daughter has recently returned from a trip to Borneo. Even with aggressive preventive anti-mosquito behaviour (long sleeves/pants, deet applications and mosquito netting) but not anti-malarial medication, she received over 30 bites. She is now exhibiting some symptoms (body aches, headache and severe fatigue). She has an appointment at the doctors in 2 days time. Is there some kind of post-trip medication (like doxycycline) she can take as a precaution even if the malarial test comes back negative at this early of a time. Thanks.

ANSWER

The important thing to note here is that if your daughter has symptoms of malaria, then she should be diagnosed and, if positive, treated with medication aimed at curing active malaria. Doxycycline is NOT a drug used for the treatment of malaria, so there is no point taking it if she is already exhibiting symptoms.

Furthermore, some types of malaria found in Borneo (notably P. falciparum and P. knowlesi) can become more severe very quickly – 2 days may be too long to wait. If you live in an area where malaria transmission occurs, you may be able to buy a self-testing kit (also known as a rapid diagnostic test, or RDT) for malaria in a local pharmacy. Otherwise, if your daughter’s symptoms get worse, you should take her to an emergency room and explain her travel history and subsequent risk of having malaria.

There is no substitute for taking prophylactic malaria medicine; it might be that if your daughter had started taking prophylactic medicine as soon as she started receiving multiple mosquito bites, then she may have been protected to some degree. However, malaria has a latent period, and so she would have had to continue taking the medication for a period of time after returning home as well – with doxycycline, this means taking the drug for a further four weeks.